To determine the sensitivity of radionuclide cineangiography in detecting coronary artery disease in patients without previous myocardial infarction, we evaluated 231 patients with coronary artery disease. Regional and global left ventricular function at rest and during exercise were assessed by analysis of regional wall motion and determination of left ventricular ejection fraction. Ninety-nine of the 231 patients had normal left ventricular wall motion, normal left ventricular ejection fraction at rest, and no Q wave on ECG. Abnormalities in regional or global left ventricular function were observed in 89 of these patients (89%). Specificity of the technique was determined in 49 patients with chest pain and normal coronary arteries; specificity was 94%. Thus, radionuclide cineangiography is sensitive and specific in detecting coronary fraction at rest and without prior myocardial infarction.